Saturday mornings are great days to write editorials, particularly when its cloudy with expectant thunder showers. With an early cup of good herbal tea in hand, I took a call from a gentleman who was very worried about his claim not being paid two years in the future because of an any occupation investigation at 24 months of paid benefits.
During the conversation I discovered he is 60-years-old and just beginning his claim with a first date of benefits due in November. Currently, he’s facing three surgeries in the next several months. Prompted by a prior poor experience with an attorney during the application process, he’s been spending many hours researching “attorney” websites and information on the Internet about “change in definition” investigations. He also told me the Unum rep shared that the company follows the decisions of SSA, and we all know isn’t true.
While I spoke with him I also discovered he was talking quite often to a Unum claims handler on the phone. When I suggested that wasn’t a great idea he began, ” Well…she’s so nice and I didn’t want to get on her wrong side…..and I wanted to show respect….and do what they asked…..etc. etc.”, I’m sure you get the picture. It was at this point I quietly set my tea on my desk pad and shook my head. I honestly don’t know where people are coming from these days. He didn’t really believe anything I was saying.
Without going into all of the particulars of our conversation, I assured this insured that it was unlikely he would be denied on the basis of an any occupation investigation because there were other factors that needed to be considered. His age, for example, the “gainful” issue, indexed or not indexed pre-disability earnings, current restrictions and limitations and several other things. There was a time at Unum when all insureds over the age of 50 were considered to be totally disabled. It’s not likely he will be sent back to another career or job at the age of 60. But, he wasn’t listening. Funny how you can tell that through a phone line, isn’t it?
Over the last several years I’ve noticed a few trends with insureds that are not helpful to them in the long run. First, finding information on the Internet and accepting it as “how it really works”, when it’s not how it really works. Second, rejection of “best practices’, even those commonly recognized in the industry. And third, not listening to the people who know. I don’t want to call it a type of arrogance, but perhaps it is, just a little.
People come to me for information because they know I do not walk on eggshells around my clients by telling them only what they want to hear. I provide information based on my knowledge, experience and expertise, and yet there is a hesitancy of disbelief. This phenomenon is also described to me by attorneys who are hell bent to help, but are turned away by clients who think only they themselves know how to do things right. So, it’s not just me, thank goodness.
In fact, in one case I am aware of, a client of an attorney acquaintance of mine began sending he and his staff nasty emails because he wasn’t doing what SHE wanted him to do. She became such an irritant that her attorney had to “set her straight” about who was in charge of the claim then on appeal.
There have been insureds who actually hired me to “assist” them but quickly became very disappointed when I didn’t do everything they told me to do. (Those of you who know me can only guess at how that one went!) As a result, several years ago I decided I couldn’t help everyone, and while I used to feel badly about it, I now let them fall into what I call, “the black hole” – that beastly place where insureds have to rely on their own know-how when they choose to ignore best practices offered by the experts
The conversation with the insured finally ended, and I could tell he wasn’t assured by my recommendations. We wished each other well, and I sincerely hope his situation turns out well. However, I’m betting he’s going to worry for two years about an any occupation investigation that may not even take place at all due to his age. I don’t even know why he called, because he wasn’t listening.
Well, my cup of tea is nearly gone and I’m just sitting here shaking my head. I guess it’s not my job to convince people to do the right thing when they are already convinced to do the opposite. Still, I hope it all works out for this insured. Oh well.
It isn’t raining yet, but I’m looking forward to it!
